| NPI | 1003916651 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: KS 04-29238) |
| Additional Taxonomies | 111NN0400X Chiropractor, Neurology (Licence: GA 081676) |
| 2084F0202X Psychiatry & Neurology, Forensic Psychiatry (Licence: GA 081676) | |
| Enumeration Date | 2006-09-24 |
| Last Update Date | 2022-03-16 |